Serum melatonin and IGFBP3 levels in the diagnosis and prognostic evaluation of age-related cataract
WANG Zhenggang
XIONG Hui
HE Ting
LIU Xiaojing
YE Yanhua
Abstract：Objective To investigate the diagnostic and prognostic value of serum melatonin(MT)and insulin-like growth factor binding protein 3(IGFBP3)levels in patients with age-related cataract(ARC).Methods This study enrolled 240 ARC patients who underwent surgery at our hospital from October 2023 to January 2025 as the ARC group,and 187 healthy individuals undergoing physical examinations during the same period as the control group.Serum MT and IGFBP3 levels were measured using enzyme-linked immunosorbent assay.Based on a 6-month postoperative follow-up,ARC patients were stratified into good and poor prognosis groups for prognostic factor analysis.Receiver operating characteristic(ROC)curves were used to evaluate the diagnostic and prognostic performance of serum MT,IGFBP3,and their combination.Results Compared with the control group,ARC patients exhibited significantly lower serum MT levels and higher IGFBP3 levels(P<0.05).For diagnosing ARC,the area under the ROC curve(AUC)was 0.817 for MT,0.792 for IGFBP3,and 0.907 for their combination,with corresponding sensitivities of 76.67%,60.00%,and 83.75%,and specificities of 73.80%,85.03%,and 83.96%.The combined detection demonstrated superior diagnostic performance compared with either marker alone(P<0.05).The poor prognosis rate among ARC patients was 30.83%(74/240).Multivariate logistic regression identified lens nuclear hardness grade Ⅳ—Ⅴ(OR=4.632,95%CI:1.702-12.609,P=0.003),elevated intraocular pressure(OR=1.341,95%CI:1.123～1.601,P=0.001),and increased IGFBP3 levels(OR=1.001,95%CI:1.001-1.002,P<0.001)as independent risk factors for poor prognosis.Conversely,greater sub-foveal choroidal thickness(OR=0.978,95%CI:0.964-0.991,P=0.001)and higher MT levels(OR=0.667,95%CI:0.577-0.771,P<0.001)were independent protective factors.For prognostic evaluation,the AUCs were 0.836 for MT,0.821 for IGFBP3,and 0.919 for their combination,with sensitivities of 58.11%,91.89%,and 85.14%,and specificities of 92.77%,54.82%,and 83.73%,respectively.The combined evaluation showed supe-rior predictive value compared with either marker alone(P<0.05).Conclusion Decreased serum MT and elevated IGFBP3 levels are associated with ARC and its poor prognosis.The combined assessment of both biomarkers provides higher diagnostic accuracy and prognostic predictive value for ARC.
Keywords：age-related cataractmelatonininsulin-like growth factor binding protein 3diagnosisprognosis
Publication Date：2026-03-10
Online Publishing Date：2026-03-20(First online date of this platform, not the publication date of the document)
Pages：7( 831-837 )